Boston: Home of the Longest Waiting Times in America and the Highest Acceptance Rates of Medicare and Medicaid 

This is good old Boston.

The home of the bean and the cod,

Where the Lowells talk to the Cabots,

And the Cabots only to God.

John Collins Bossidy (1860-1928), On the Aristocracy of Harvard

And here’s more on good old Boston.

The home of the architects of the Affordable Care Act.

The home of RomneyCare,   the model for the Affordable Care Act.

The home of David Cutler,  PhD, a Harvard economist and the President’s  chief medical advisor in his 2008 campaign.

The home of David Blumenthal,  MD,  the president’s first health information czar and one of the fathers of electronic health records.

The home of Donald Berwick, MD,  the first CMS administrator appointed by the President, and now Democratic candidate for governor in that state.

The home of the highest concentration of primary care physicians in the U.S. per square mile if one excludes Washington, D.C,  the distal  end of the Washington-Boston intellectual axis.

And the  home of the longest physician waiting times for appoointments  among major metropolitan areas,  in  Merritt Hawkins periodic surveys (2004,2009, and 2013).

Here are the key findings of Merritt Hawkins 2013 survey of waiting times and Medicaid and Medicare acceptance rates among 15 major metropolitan areas.

·         At 45.4 days, Boston had the highest cumulative wait time for a physician appointment, a distinction it also had in 2004 and 2009.

·         The average appointment waits to see a family physician ranged from a high of 66 days in Boston to a low of 5 days, in Dallas.

·         The average wait time to see an obstetrician-gynecologist ranged from a high of 46 days in Boston to a low of 10 days in Seattle.

·         The average wait time to see a dermatologist ranged from a high of 72 days in Boston to a low of 16 days in Miami.

·         The average cumulative wait time to see a family physician in all 15 markets was 19.5 days.

·         The average cumulative wait time to see physicians for all 5 specialties (cardiology, family practice, dermatology, Ob-Gyn, orthopedics) was 18.5 days.

·         Boston had the highest cumulative average rate of Medicaid acceptance by physicians in 15 markets surveyed at 73% while the average was 45.7%, down from 55.7% in 2009 and 49.9% in 2004.

·         Of the 15 markets surveyed, Boston had the highest rate of Medicare acceptance at 98% while Minneapolis had the lowest 38.2% while the cumulative average was 76%.

·         The markets surveyed included Atlanta, Boston, Dallas, Denver, Detroit, Houston, Los Angeles, Miami, Minneapolis, New York, Philadelphia, Portland, San Diego, Seattle,  Washington, D.C.: 1399 medical offices were surveyed. 

Conclusion

Here is Merritt Hawkins conclusion (for details you can find the entire survey results on the web),
 

“At 45.4 days, Boston has the highest cumulative average wait time for a physician appointment of the 15 metropolitan markets surveyed. Boston also had the highest average waits times when the survey was conducted in 2009 and 2004. The average appointment wait time to see a family physician ranged from a high of 66 days in Boston to a low of 5 days in Dallas. However, as the example of Boston illustrates, access to health insurance does not always guarantee access to a physician. In addition, the survey demonstrates that many if not most physicians in the 15 markets examined are not accepting Medicaid as a form of payment. It is our intention to bring the physician supply discussion into practical focus and to determine how health reform and related trends are affecting access to physician services.”

Boston is a city of health care extremes.  It has the highest premiums in the land, the lowest number of uninsured, the longest waiting times,  the highest acceptance rate of Medicare and Medicaid.  It is an example of rationing by waiting.  It is probably not representative of America as a whole, but what American health care might look like if progressives win the day and have their way.

Tweet:  Of 15 major metropolitan areas,  Boston has the highest average wait times for a physician appointment, the highest Medicare acceptance rate (98%), and the highest rate of Medicaid acceptance (73%),